某院慢性心力衰竭患者沙库巴曲缬沙坦的临床使用情况分析  

Analysis of Clinical Use of Sacubitril Valsartan Sodium in Patients with Chronic Heart Failure in a Hospital

作　　者：马敏亚 平慧[1] 陈怡 金钰[1] MAMin-ya;PING Hui;CHEN Yi;JIN Yu(Changshu No.2 People's Hospital,Changshu Jiangsu 215500,China)

机构地区：[1]常熟市第二人民医院,江苏常熟215500

出　　处：《抗感染药学》2023年第8期825-829,共5页Anti-infection Pharmacy

摘　　要：目的:分析医院慢性心力衰竭(chronic heart failure,CHF)患者沙库巴曲缬沙坦的临床使用情况,为临床沙库巴曲缬沙坦的安全、合理使用提供参考。方法:利用医院信息系统选取2020年1月—12月常熟市第二人民医院心血管内科190例使用沙库巴曲缬沙坦治疗的CHF患者作为研究对象,采集患者的左室射血分数(left ventricular ejection fraction,LVEF)、既往用药史和沙库巴曲缬沙坦的用法用量、疗程、疗效、药物不良反应等信息,分析患者沙库巴曲缬沙坦的临床使用情况。结果:190例CHF患者均符合沙库巴曲缬沙坦的用药适应证,其中183例治疗前LVEF≤40%,其余7例治疗前LVEF>40%但有CHF症状须控制;沙库巴曲缬沙坦的初始方案主要为“25 mg,q12h”(88例,占46.32%)和“50 mg,q12h”(97例,占51.05%),“100 mg,q12h”仅有5例,而维持治疗方案主要为“50 mg,q12h”(83例,占43.68%)和“25 mg,q12h”(62例,占32.63%),合计有123例(64.74%)患者未调整治疗方案;在190例患者中,有101例(占53.16%)既往正在服用血管转化酶抑制剂或血管受体阻断剂,但在改变治疗方案时,有8例使用血管转化酶抑制剂的患者的药物转换间隔时间小于36 h;在用药疗程方面,疗程>1年的有68例(占35.79%),疗程为>6个月~1年的有17例(占8.95%);在治疗过程中,有22例(占11.58%)患者达到靶剂量治疗目标,其中2例的维持方案为“200 mg,q12h”,其余20例则为最高耐受剂量维持;在85例疗程>6个月的患者中,沙库巴曲缬沙坦明显有效的有49例,有效的有26例,基本无效的有10例;190例患者中有28例(占14.74%)在用药过程中出现药物不良反应,其中低血压反应22例、肾功能损害4例、高血钾反应2例,但经处置后所有患者均好转。结论:医院临床在对沙库巴曲缬沙坦的适应证把握和用药转换的处理上基本是合理的,但在靶剂量的达标方面尚有欠缺,这是影响患者用药疗效的重要指标,临床应当加强患者�Objective:To analyze the clinical use of sacubitril valsartan sodium in patients with chronic heart failure(CHF)in the hospital,and provide reference for the safe and rational use of sacubitril valsartan sodium in clinical practice.Methods:By using the hospital information system,190 CHF patients treated with sacubitril valsartan sodium in Cardiovascular Medicine Department of Changshu No.2 People's Hospital from January to December 2020 were selected as the research subjects.The information such as left ventricular ejection fraction(LVEF),past medication history,and information on usage and dosage,treatment course,efficacy,and adverse drug reactions of sacubitril valsartan sodium was collected to analyze the clinical use of Sacubitril Valsartan Sodium in patients.Results:190 CHF patients all met the indications for use of Sacubitril Valsartan Sodium.Among them,183 patients had LVEF less than or equal to 40%before treatment,while the remaining 7 patients had LVEF more than 40%before treatment but had CHF symptoms that needed to be controlled;the initial regimen of sacubitril valsartan sodium was mainly"25mg,q12h"(88 cases,46.32%)and"50mg,q12h"(97 cases,51.05%),with only 5 cases of"100mg,q12h",while the maintenance treatment regimen was mainly"50mg,q12h"(83 cases,43.68%)and"25mg,q12h"(62 cases,32.63%),with a total of 123 patients(64.74%)not adjusting the treatment regimen;among 190 patients,101(53.16%)had previously been taking angiotensin converting enzyme inhibitors or vascular receptor blockers,but 8 patients who used angiotensin converting enzyme inhibitors had a drug conversion interval of less than 36 hours when changing the treatment regimen;in terms of medication course,68 cases(35.79%)had a treatment course greater than 1 year,and 17 cases(8.95%)had a treatment course greater than 6 months to 1 year;during the treatment process,22 patients(11.58%)achieved the target dose treatment target,with 2 patients receiving a maintenance regimen of"200mg,q12h"and the remaining 20 patients receiving the highest toler

关 键 词：沙库巴曲缬沙坦 慢性心力衰竭 合理用药 

分 类 号：R969.3[医药卫生—药理学]